Individual provider Active NPI

Michael F Kivlighan, DDS

  • General Practice Dentistry
  • Waynesboro, VA
National Provider Identifier
1720149644
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
2775 Issued in VA
Practice address
1305 13TH St Unit D 2
Waynesboro, VA 22980-3631
Phone
(540) 943-1222
Fax
(540) 943-1555
NPI assigned
Dec 13, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 2775 VA Primary

Addresses

Primary practice location

1305 13TH St Unit D 2
Waynesboro, VA 22980-3631

Mailing address

1305 13TH St Unit D-2
Waynesboro, VA 22980-3631
Phone (540) 943-1222

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
2775VAMDGeneral Practice Dentistry

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1165968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1720149644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1305 13TH ST UNIT D-2",
            "city": "WAYNESBORO",
            "state": "VA",
            "postal_code": "229803631",
            "telephone_number": "540-943-1222",
            "fax_number": "540-943-1555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1305 13TH ST UNIT D 2",
            "city": "WAYNESBORO",
            "state": "VA",
            "postal_code": "229803631",
            "telephone_number": "540-943-1222",
            "fax_number": "540-943-1555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIVLIGHAN",
        "first_name": "MICHAEL",
        "middle_name": "F",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "2775",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waynesboro, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.